Tuberculosis

Navoditte Das A2

Tuberculosis (TB) is caused by the bacterium Mycobacterium

tuberculosis. Robert Koch first identified it in 1882. Viewed under the
microscope after Ziehl-Neelsen staining, the cells show up bright
red.
TB is transmitted by droplet infection (i.e. a person infected with TB
coughs, talks or sneezes and droplets of water and mucus are
released into the air from the lungs. These droplets contain the TB
bacteria. The droplets are inhaled by a second person, who is then
infected with the disease.)
TB affects the lungs predominantly, but can spread to other parts of
the body e.g. lymph (causing scrofula) or the blood (causing sepsis).
TB has a thick waxy cell wall, which stops it from breaking down. It
can, therefore, survive as dust from dried droplets for weeks. TB can
survive inside macrophages (cell wall of the bacterium is very thick
and waxy and is resistant to the macrophage enzymes). The
bacterium reproduces inside the macrophage for many years
without causing infection. Its lipid rich walls act as a food source.
When the immune system is weakened (by stress, malnutrition, or
another disease HIV is a common cause) the TB bacterium breaks
out and re-infects the body. This is a secondary infection, not a true
re-infection.
TB is characterised by fever, cough, blood in sputum, weight loss (it
used to be known as consumption for this reason).Also, the
presence of granulomas in a lung x-ray, which is often how TB is first
diagnosed.
TB targets T cells, disarming a critical response of the immune
system. Thus sufferers become vulnerable to opportunistic
infections such as pneumonia. They might also die from lack of
oxygen or damaged organs. TB is temperature sensitive, and stop
reproducing at 42 C.
The main treatment is by antibiotics for many months, usually a
mixture of antibiotics to prevent the mycobacterium from
developing any resistance or immunity. It also kills the hidden
bacteria, e.g in cysts. The best way to prevent TB is to improve
living standards, i.e less crowding and better working conditions.
Since TB can also be transmitted by contaminated milk,
pasteurization can prevent this method of spread of the disease. In
developed countries, people in close contact with a TB patient can
be easily identified, contacted, tested and immunized. The BCG

vaccination is very common and effective in the UK. However

recently there has been a great increase in TB cases, perhaps due to
deteriorating social conditions, immigration, and movement of
refugees, increasing IV drug use and more people suffering from
HIV/AIDS. There has also been the development of multi resistant
strains of mycobacterium tuberculosis.